Adult Dance Music Mommy & Me
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Adult Summer Session To register please fill out the highlighted fields. Your Name/s Phone Email Select class from the menu below Please select class Salsa 101 7/7 - 8/4, $60 - Wednesday 8:00-9:00pm Please select whether you are registering a single person or couple Single Person Couple
How did you hear about us? Websearch Around Woodstock Magazine Billboard The Townlaker Magazine Cherokee Ledger Flyer Friend Passing By Other Registration will be complete once payment is received. To make a payment please contact the studio 770-924-1661 or follow the PAY NOW link once you submit this form. .
Payments are non-refundable, but can be used as credit towards other classes. I/WE (your name/s) of (your address) State of Georgia; am/are enrolled as a student in a course of instruction with the studio of Neta Thurman, t/a DANCE AND MUSIC ACADEMY OF WOODSTOCK LLC, of Woodstock, Georgia. By enrolling myself/us in this course I/WE certify that I/WE am/are aware of the possibility of injury in connection with the activities connected therewith. I/WE understand and agree that neither the owners, operators, agents, or instructors, including but not limited to Neta Thurman, may be held liable in any way for any occurrence in connection with the studio which may result in injury or other damages to myself/us or my family heirs or assigns. In consideration of enrolling myself/us in this course, I/WE hereby personally assume all risks in connection with the course, and I/WE further release the instructors, program agents, and operators, including but not limited to the persons mentioned, of any injury of damage which may befall myself/us while I/WE am/are enrolled as a student of the school, including all risks connected therewith, whether foreseen or unforeseen; and further, to save and hold harmless the program and persons from any claim by or on behalf of my family, estate heirs, or assigns, arising out of the my/our enrollment and participation in the course. I/WE further state that I/WE am/are of lawful age and legally competent to sign this affirmation and release; that I/WE understand the terms herein and contractual and not mere recital; and that I/We have signed this document as my/our free act. I/WE have fully informed myself/ourselves of the content of this affirmation and release by reading it before I/WE signed it. IN WITNESS WHEREOF, I/WE have executed this affirmation and release on (date: mm/dd/yy) . Submission of this form with Name and Date serves as acknowledgement of and agreement with the above statement, and gives Dance and Music Academy of Woodstock permission to charge my credit card the amount selected above.
I/WE further state that I/WE am/are of lawful age and legally competent to sign this affirmation and release; that I/WE understand the terms herein and contractual and not mere recital; and that I/We have signed this document as my/our free act. I/WE have fully informed myself/ourselves of the content of this affirmation and release by reading it before I/WE signed it.
IN WITNESS WHEREOF, I/WE have executed this affirmation and release on (date: mm/dd/yy) .
Submission of this form with Name and Date serves as acknowledgement of and agreement with the above statement, and gives Dance and Music Academy of Woodstock permission to charge my credit card the amount selected above.
